MEDICARE: JASON L MELTON PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2914	NV

General Provider Information

NPI Number	:	1013348754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON L MELTON PT, DPT

Provider Business Mailing Address
First Line	:	3041 W HORIZON RIDGE PKWY STE 140
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-4445
Country	:	US
Telephone Number	:	702-565-6565
Fax Number	:	702-565-8898

Provider Business Practice Location Address
First Line	:	3041 W HORIZON RIDGE PKWY STE 140
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-4445
Country	:	US
Telephone Number	:	702-565-6565
Fax Number	:	702-565-8898

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2013
Last Update Date	:	01/04/2022

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